Central Todd County Care Center, Inc.

Key facts

NPI: 1003899402
Entity type: Organization (NPI type 2)
Primary specialty: Skilled Nursing Facility 314000000X
License: 328579 (MN)
Legal business name: CENTRAL TODD COUNTY CARE CENTER, INC.
Practice address: 406 Highway 71 E
Clarissa, MN 56440-2000
Phone: (218) 756-3636
Fax: (218) 756-2276
NPI assigned: Nov 21, 2005
Organization subpart: No

Authorized official

Name: Mr. Jason E Polovick, LNHA
Title: Nursing Home Administrator
Phone: (218) 756-3636

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Rene Eldidy Jr., M.D. Family Medicine Physician · Long Prairie, MN · NPI 1457342032

NPD (past)
Julie Catherine Mayers Benson, M.D. Family Medicine Physician · Staples, MN · NPI 1720078728

NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Julie Catherine Mayers Benson, M.D. Family Medicine Physician · Staples, MN · NPI 1720078728

Care Compare affiliation Nursing home

Medicare Care Compare: Nursing home

Listed as: Central Todd County Care Center CCN 245521
Overall star rating: ★★★★★ 5 of 5
Health inspections: ★★★★☆ 4 of 5
Staffing: ★★★★★ 5 of 5
Quality measures: ★★☆☆☆ 2 of 5
Type: Medicare and Medicaid
Ownership: Non profit - Corporation
Certified: Feb 1, 1988
Medicare certification status: Active (Provider of Services file)
Certified beds: 45 · 39.4 residents per day on average

Source: Medicare Care Compare, processed Aug 1, 2026.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
24D0651664	Central Todd County Care Center 406 East Highway 71, Clarissa, MN 56440	Certificate of waiver	Aug 31, 2026

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MN

Skilled nursing facility certification: CCN 245521

Legal name: CENTRAL TODD COUNTY CARE CENTER, INC.
Certification status: Active
Provider type (POS): Nursing home – SNF/NF dual certification
Participating since: Feb 1, 1988
Last certification: Feb 26, 2025
Beds: 45
Ownership / control type: Nonprofit Corporation
Organization structure: Corporation · Non-profit
Incorporated: Mar 25, 1977 in MN
Enrollment address: 406 Highway 71
Clarissa, MN 56440-2000
Nursing home name: CENTRAL TODD COUNTY CARE CENTER

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Name	Role	Since	Share
Randy Lavoie Individual	Corporate Director	Jan 20, 2009
Jason Polovick Individual	W-2 Managing Employee Administrator	Jan 20, 2009	100%
Heather Lancaster Individual	Corporate Director Board Member	Jan 15, 2019
Robert Anderson Individual	Corporate Director	Jan 20, 2009
Peggy Carlson Individual	Corporate Director Board Member	Jun 1, 2012
Larry Dickinson Individual	Corporate Director Governing Board President	Jan 20, 2009

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20100611000628	MN	Part a Provider - Skilled Nursing Facility	2365572617	Practice locations: Clarissa, MN

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Assisted Living Facility	310400000X	329956	MN
Skilled Nursing Facility	314000000X	328579	MN	Yes

Addresses

Primary practice location

406 Highway 71 E
Clarissa, MN 56440-2000

Mailing address

PO Box 38
406 East Highway 71
Clarissa, MN 56440-0038
Phone (218) 756-3636

Other identifiers

Identifier	Type	State	Issuer
785540100	Medicaid	MN

Other providers in Clarissa, MN

All providers in Clarissa, MN · Skilled Nursing Facility in Minnesota

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 20, 2011. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
Provider of Services files (CMS): certification status, beds and related CCNs.
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.